Health Insurance in 2026
Health insurance rates for 2026 are the ugliest we’ve seen in decades. After 30 years in this business, we can honestly say: this year is different.We’re already seeing families in Arizona going from around $300 a month to over $1,100 a month just to keep their health insurance. That kind of jump can wreck a budget if you’re not prepared.
The good news? You are not stuck. But you do need to understand your options and make smart moves now.
Here are 5 important points you need to know about health insurance in 2026 and how MAPFL can help protect your wallet.
MAPFL BLOG
5 Things You Need to Know Before Your Rates Explode
1. The Marketplace Isn’t Always Your Best (or Only) Option
The Affordable Care Act marketplace can still be a good tool, but in 2026 it’s also where a lot of the pain is showing up.
- Some families are seeing their premiums triple.
- A client paying $370 a month is now looking at $1,107 for the same style of coverage.
- If you just auto-renew without reviewing your options, you could be leaving thousands of dollars on the table.
When the marketplace can still make sense:
- You have serious or ongoing health conditions.
- Someone in your household needs consistent, specialized care.
- You rely heavily on specific doctors or hospitals that are tied to marketplace plans.
In short: the marketplace is one tool, not the only tool. For many healthy individuals and families in 2026, staying there by default could be the most expensive choice.
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During the pandemic, subsidies were temporarily expanded up to about 700% of the federal poverty level. Now we’re back to the older rule: 400% of the poverty level. That means:
- At one income level, you might qualify for an $800/month subsidy.
- If your income crosses above the threshold, you may get no subsidy.
- If your income estimate is wrong, you might have to pay back thousands (for example, $9,600) at tax time.
If you’re relatively healthy, there are alternatives, including:
- Short-term major medical plans.
- A “combined protection” strategy using two plans:
- One plan for everyday and outpatient care (often with no deductible).
- A second plan for big, catastrophic claims like hospital stays or major surgeries.
- One plan for everyday and outpatient care (often with no deductible).
This approach can significantly reduce monthly costs and, in some cases, cover so much of a large bill that you end up owing very little—or even coming out ahead on the claim—depending on the plan design.
2. Mixed-Health Families Can Split Coverage to Save Big
Here’s where strategy really matters.
If you have a family of five, and one child (let’s call him “Little Joey”) has a significant medical issue, you don’t necessarily have to keep everyone on the same expensive marketplace plan.
A smart approach:
- Keep the person with serious health issues (Little Joey) on the marketplace plan to protect access and benefits.
- Move the healthy family members to alternative coverage that can cost 50–70% less per month.
This kind of split strategy can:
- Keep the medically fragile family member fully protected.
- Dramatically reduce the total monthly premium for the household.
- Prevent rate shock from swallowing 15–20% of your income.
But this has to be designed correctly. You need someone who understands how to layer plans without creating dangerous gaps.
3. The Subsidy Rules Changed Again – And They Can Hurt You
During the pandemic, subsidy eligibility was temporarily expanded from 400% of the federal poverty level (FPL) up to around 700% of FPL. That meant more middle-income families qualified for help.
That’s gone.
We are back to the old 400% of FPL rules. That means:
- At one income level, you might qualify for an $800/month premium subsidy.
- If you go just a bit higher, you might get no subsidy at all.
- If your income estimate is off, you could owe back $9,600 or more at tax time.
If your income is:
- Variable
- Commission-based
- Seasonal, or
- Growing quickly
Staying in the marketplace can be risky if you’re healthy. One year-end tax surprise can erase an entire year of “affordable” premiums.
For many healthy people with fluctuating income, it can make more sense to move out of the marketplace altogether.
4. Short-Term and “Combined Protection” Plans Can Cut Costs (If You’re Healthy
If you’re relatively healthy, there are two powerful directions to consider:
- Short-Term Major Medical Plans
These can offer strong protection for big, unexpected medical events at a much lower monthly cost than many marketplace plans. - Combined Protection Approach
This is a strategy we love at MAPFL. Instead of one expensive plan trying to do everything, we combine two:- Plan A: Handles the “little stuff” – doctor visits, outpatient care, minor procedures, often with no deductible.
- Plan B: Handles the “big stuff” – catastrophic events, hospital stays, major surgeries.
- Plan A: Handles the “little stuff” – doctor visits, outpatient care, minor procedures, often with no deductible.
How it can work in real life:
- A conventional plan might have a $5,000 deductible, 70/30 coinsurance, and another $4,500 out-of-pocket max.
On a $25,000 bill, you could be out $9,500 before insurance fully kicks in. - With a combined approach that uses an indemnity-style plan (for example, a plan administered by Golden Rule under UnitedHealthcare), the company applies a schedule of benefits after applying their contracted discounts.
- Result: most of that $25,000 bill can be wiped out — and in some cases, you may even come out ahead on the claim.
In practical terms:
- You carry two cards.
- For routine care, you may only need the “little stuff” card with minimal or no deductible.
- If you land in the hospital, you hand them both cards. They bill both policies.
- Whatever is left over after both plans pay may even be paid to you, depending on the design.
This is not a one-size-fits-all solution, but for the right healthy households, it can be a game changer.
5. The Real Risk: How Much of Your Income Goes to Insurance
Premiums in 2026 aren’t just numbers; they’re percentages of your life.
- If you’re paying around $100 a month on a lower income, that might be about 5% of what you make. Annoying, but manageable.
- What worries us are the families who will be forced to pay 12%, 15%, even 20% of their income just to keep health insurance.
At that point, you’re no longer buying “peace of mind” – you’re funding a financial crisis.
This is why having an experienced broker matters more than ever:
- Someone who understands the difference between marketplace and non-marketplace solutions.
- Someone who knows how to split coverage inside a family when it makes sense.
- Someone who can explain the tax and subsidy risks in plain English.
- Someone who can design a short-term or permanent plan that may cut your cost by half while still protecting you from big medical events.
At MAPFL, this is exactly what we do for Arizona families every day.
How MAPFL Can Help You Right Now
If you’re looking at your 2026 renewal and feeling sick to your stomach, you’re not alone—and you’re not stuck.
MAPFL can help you:
- Review your current plan and your new 2026 rates.
- See if you or your family members should stay in the marketplace or move off it.
- Explore short-term, major medical, and combined protection strategies.
- Design a permanent plan that could cost up to 50% less than what you’re being quoted.
You shouldn’t have to sacrifice 15–20% of your income just to stay insured.
Let us help you find an affordable, smarter way to protect your health and your wallet for 2026 and beyond.
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